What to expect when you call an ambulance
You’re driving on Route 28 or Route 6 and check your rearview mirror to see flashing red lights and the sound of a siren behind you. Your first instinct is to get out of the way. You don’t think about what is going on in the ambulance and probably don’t give it a second thought that you may be a patient in the back of one someday.
What you also may not realize is that the paramedics and EMTs staffing the ambulances on Cape Cod are also local firefighters. While they may be saving a life one day, they could be putting out a fire and rescuing people from a burning building the next.
Cape Cod Health News talked with Cape Cod Hospital Emergency Medicine physician Jacob Crowell, MD; Nicholas Black, a paramedic with the Barnstable Fire Department; and Jason Silva, paramedic, a lieutenant, and director of EMS for the Bourne Fire Department, about what goes on during an ambulance trip to the hospital. They also offered some helpful information should you ever find yourself in that position.
It all begins with a phone call.
“Call 911!!!” said Black. “We get a lot of people who call our business line and that is not the fastest way to get us to you. There are many times when we may be returning from a run to the hospital at a training or out of the building for another reason. When you call 911, the dispatcher will call us, and we will come to you from wherever we are.”
“We often respond to calls where people will delay calling for help," said Silva. "My advice is not to wait to call. Sometimes, people who really need an ambulance are hesitant to call or they fall and they don’t want to call. Stroke symptoms, chest pain and those types of symptoms can just get worse as time goes on, so it is always best to call right away rather than waiting it out. We’re here 24 hours-a-day, seven days-a-week, to be used when needed.”
The following are some of the most common questions asked about ambulance calls.
Do you have to go to the hospital if you call for an ambulance?
“The biggest message I can get out there is EMTs, and paramedics are not allowed to suggest that you don’t go to the hospital, they are required by the state to advise everyone to go to the hospital,” said Dr. Crowell. “If a patient does not want to go to the hospital, they have every right to refuse to be transported. The EMS crews are very willing and able to provide initial stabilization and treatment and can facilitate the patient refusing transport, if that is what they want.”
Do you need to provide a medical history and medication list for the EMTs?
“Anyone who gets their care within Cape Cod Healthcare will already have their information in the Epic (electronic medical) record system,” said Dr. Crowell. “You need to bring little other than your most recent medication list. For patients who get their care outside of the system, the more information about past medical history, current medications, and allergies, the better.”
What happens when the ambulance arrives?
“We gather all our information: history, present illness, and what is going on,” said Black. “We start treating in the house, checking the EKG, vital signs, and we can get more invasive if we need to. The bag we bring in with us is equipped to start IVs and includes medications.
“If the patient is hypoglycemic, we start an IV and give dextrose. If they are talking to us, we can give oral glucose. For chest pain, we give aspirin, start an IV, and give nitroglycerin, if their blood pressure allows. If a person has overdosed, we can give Narcan.”
“First-line treatment for most medical situations can be provided by a paramedic without talking with a physician,” said Dr. Crowell. “The state-wide protocols outline what can be done as a standing order and also outline other interventions that can be done based upon a verbal order from a physician.”
How do the ER physicians and staff know what to expect in a patient coming in an ambulance?
“We call the ER on our way to let them know what is going on,” said Black. “We give them the patient’s age, gender, the treatments we’ve started in the ambulance, whether they have helped or not and our estimated time of arrival.”
When a patient arrives, they are assigned to a room or patient care area based upon how urgent the need is, said Dr. Crowell.
“The quicker you see us move, the more concerned you need to be. If we are not moving quickly, that is usually a good sign.”
Can a family member ride in the ambulance?
“If it’s a pediatric patient, we prefer to have a parent in the back of the ambulance with us,” said Black. “They keep the child calm and make everything go a lot smoother. The parent must ride seat-belted on the seat bench next to the child. They can’t hold them or have them in their lap. The child is secured using a pediatric restraint system, which is built for stretchers. If we are transporting an adult, a family member can accompany them, but they must ride, seat-belted, up front with the driver.”
Can patients request the hospital they want to go to?
“Sometimes, the paramedic is making the decision to take you to the closest hospital because they think that is the best thing for you, or they take you to a hospital where they think you may need a cardiac catheterization, if it’s a heart problem,” said Silva. “They can’t take you to Falmouth Hospital (for catheterization) because they don’t do that procedure there, but they do at Cape Cod Hospital. I think people have a hard time understanding we make a transport decisions based on the patient’s condition we are faced with.”
